在选择性腹腔镜胆囊切除术中,OSTAP,ESP阻断,三关节部位局部麻醉注射的有效性:一项随机对照试验
Burak Nalbant1,2, Asli Donmez3,4, Savas Altinsoy3,4
1Department of Anesthesiology, Ankara Yildirim Beyazit University, Ankara, Turkey.
Medicine
|August 5, 2025
概括
勃起器脊柱平面 (ESP) 块和斜肋下横向腹部平面 (OSTAP) 块在腹腔镜胆囊切除术后显著减少了术后阿片类药物使用. 与OSTAP阻断和局部麻醉透相比,ESP阻断显示出更好的疼痛控制.
科学领域:
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
- 外科手术止痛疗法
背景情况:
- 腹腔镜胆囊切除术 (LC) 后的术后疼痛控制是一个重大的临床挑战.
- 区域麻醉技术,包括勃起器脊柱平面 (ESP) 阻断和斜肋下横向腹部平面 (OSTAP) 阻断,正在成为传统疼痛管理的替代方案.
- 对比这些阻塞对局部麻醉透的止痛效果对于优化患者康复至关重要.
研究的目的:
- 为了比较ESP阻断,OSTAP阻断和三部位局部麻醉 (LA) 透在接受LC的患者中的止痛效果.
- 评估这些技术对术后疼痛评分和阿片类药物消费的影响.
- 评估额外的止痛药需求,恶心吐和肩部疼痛的发生率.
主要方法:
- 这是一项双盲,随机对照试验,涉及100名接受LC治疗的患者.
- 患者被随机分为四组:ESP阻断,OSTAP阻断,托拉卡部位LA透,以及接受多式止痛药的对照组.
- 使用视觉模拟尺度 (VAS) 评估疼痛,在手术后24小时内记录特拉马多尔消费和其他结果.
主要成果:
- 与对照组相比,ESP和LA透组的VAS得分明显较低.
- 与对照组和LA透组相比,ESP和OSTAP区组的特拉马多尔总摄入量显著降低.
- 与对照组相比,所有干预组 (ESP,OSTAP,LA) 的额外止痛药需求都较低,恶心-吐或肩膀疼痛没有显著差异.
结论:
- 单边ESP和OSTAP阻断有效地减少了LC后的术后阿片类药物需求.
- 与OSTAP阻断和局部麻醉透相比,ESP阻断显示出更高的疼痛控制效果.
- 这些区域麻醉技术可以成为LC患者多式联络止痛策略的有价值组成部分.
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